Individual provider Active NPI

Jude M. Treder-Wolff, LCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1730192543
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040325-1 Issued in NY
Practice address
496 Smithtown Byp
Suite 202
Smithtown, NY 11787-5005
Phone
(631) 366-4265
NPI assigned
Aug 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R040325-1 NY Primary

Addresses

Primary practice location

496 Smithtown Byp
Suite 202
Smithtown, NY 11787-5005

Mailing address

15 Oneida Ave
Selden, NY 11784-3715
Phone (631) 698-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060424000031 NY Practitioner - Clinical Social Worker 5890705743 Practice locations: Selden, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Oneida Ave
Selden, NY 11784-3715
Phone (516) 848-5069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040325-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Counseling Services LCSW PLLC Clinical PastSince May 12, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730192543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ONEIDA AVE",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117843715",
            "telephone_number": "631-698-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE 202",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-366-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREDER-WOLFF",
        "first_name": "JUDE",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040325-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.